Organization Active NPI

Psychology Practice

  • Adult Mental Health Clinic/Center
  • Baldwin, NY
National Provider Identifier
1356700066
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
008773 Issued in NY
Legal business name
PSYCHOLOGY PRACTICE
Practice address
865 Merrick Rd
#305
Baldwin, NY 11510-3338
Phone
(516) 868-3421
NPI assigned
Feb 23, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Leroy V. Monroe, PH.D.
Title
Psychologist
Phone
(516) 868-3421

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X 008773 NY Primary

Addresses

Primary practice location

865 Merrick Rd
#305
Baldwin, NY 11510-3338

Mailing address

865 Merrick Rd
#305
Baldwin, NY 11510-3338
Phone (516) 868-3421

Other identifiers 1

IdentifierTypeStateIssuer
01572229MedicaidNY

National Provider Directory

National Provider Directory

Locations

865 Merrick Rd
#305
Baldwin, NY 11510
Phone (516) 543-5397

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456185600000",
    "number": "1356700066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 MERRICK RD",
            "address_2": "#305",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103338",
            "telephone_number": "516-868-3421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 MERRICK RD",
            "address_2": "#305",
            "city": "BALDWIN",
            "state": "NY",
            "postal_code": "115103338",
            "telephone_number": "516-868-3421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "516-868-3421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NY",
            "license": "008773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01572229",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwin, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.